Small-town living certainly has its perks, but one that isn’t always among them is preparedness for a wide variety of medical emergencies.

In many rural areas, there is only one doctor, who is often a general practitioner, on call for trips to the emergency room. This can spell trouble for patients stricken by heart attacks or hurt in car accidents who are subsequently forced to travel hundreds of miles to the nearest big city hospital.

To solve this problem, communities all over rural South Dakota, North Dakota, Minnesota, Iowa, Wyoming and Nebraska are sending their critically injured patients to a somewhat virtual hospital. The Avera Health Network, a nonprofit that offers a wide range of “telemedical” services, has experts on call 24-hours a day to diagnose patients via Skype and video chat.

Based at Avera McKennan Hospital in Sioux Falls, South Dakota, the virtual hospital is set up to provide support to doctors serving rural areas across the United States. While the doctors at Avera monitor ICU patients via Skype, the patients themselves are surrounded by nurses and pharmacists, ensuring the long-distance physicians aren’t missing anything vital.

The Avera team calls this "hands in pocket doctoring." Of course, physical hands are needed to carry out virtual orders, and real doctors and nurses are always on hand to provide that. But even IRL (in real life), crisis situations require someone at the head of the room, keeping tabs on everyone and calling the shots. In emergency situations, where every second counts, the long-distance physician is able to be in the room an average of 14 minutes sooner than the local doctor.

Working together, the long-distance docs and local nurses and pharmacists have seen an 18 percent decrease in ambulance and helicopter transfers to bigger hospitals, saving a total of $6.6 million.

"The magic is being able to see into room," Jay Weems, executive director of one of the virtual services told The Atlantic. "But the bigger magic, we think, is the people are on both ends — in the rural community and in the hub — that support each other and work together as team, as medicine is meant to be practiced."

Contributing Editor
Sarah Korones is a freelance writer based in New York. She has written for Psychology Today and Boston's Weekly Dig. She holds a degree from Tufts University.
Follow her on Twitter.